57304D - Rafferty

4CAMA / DREDGE & FILL
3 E N E RAL PERMIT Previous permit #
iNevv -Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources T _ l
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC H <' CJ V
tfl Rules attached.
it Name ) �(1 Pr c'Ei'i-�l tT �K �'1� ' � Project Location: County . al'i SLAJ / C ,-
jF( `�{s f .N7UC K t f AVE S-E /t)�T Street Address/ State Road/ Lot #(s)
JJA Sht ti(,-ITN _Y_ State ZIP ? szz L 1=- �LZ I c til -(X
` ( ) I — J Fax # () Subdivision
:ed Agent �� r 7SN Ct7- Ito (4 }1 City �/4"K 1 SL 7-i� ZIP Z�S '
cw
OEA
PWS:
yes / no
DEW Vi PTA ETES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FO
PNA es / no Crit.Hab. yes / no
Phone # ( ) River Basin C/YC-
Adj. Wtr. Body IPCNT 6C &1 C?eq J—L"tf �a h
Closest Maj. Wtr. Body A I w w
f Project/ Activityr/<') ✓ i+77. 6 (L-K&L-fiZ)
(Scale:
ck) length
t(s)
ier(s)
ngth
tuber
d/ Riprap length
distance offshc
uc distance offsh
cannel
Dic yards
np
ise/ Boatlift
ulldozing
e Length
not sure
s: not sure
ium: n/a
kttached: _
ng permit may be required by: OA 4 I5Ir*t-"9
❑ See note on back regarding River Basin n

North Carolina Department of Eu onme t and Natural Re
Division of Coastal Management sources
Michael F Eas;ey, Governor James H. Gregson, Director
William G. Ross Jr
Authorized Agent Consent Agreement
(Pnn e4Name ofAgent) is hereby authorized to act on my b,
order to obtain any CAMA permit(s) required for the property listed below. The authorization is limit
ecific activities described in the attached sketch. ed
)CATION OF PROJECT:
DPERTY OWNER MAILING ADDRESS:
s�
C (D PHONE NO
HORIZED AGENT MAILING ADDRESS:
yS7-�3g1 g 0

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American Fish Company
Alk
P.O. Box 11046
Southport. North Carolina 28461
Email: AFC036000ad com
'i j -j a 4 4
Ak
I �o�sT S�o�tc�h
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3
INVOICE NO #
µ
38,
(910)457-548E
[phone]
R
F,xeb DecK
6i 1

Name of Individual APF Y { in
g For Pemut:
address of Property 3 ��
,Lcr or Street is, Street or Road)
`C►ry and County)
;,cieoy certify ti�� t I own property Adjacent to the acove•refere eo r
apPly';n9 for this Permit h1as described CO me US shown on the a r prop
are pToposin¢. A csc*ing
ption or drawing, with dimensions, shonlj be rovid
t1�ccK P
kcft•---� I ,have no objections to s4s pr000sal
If you have objections to wllnt i9 being proosod le
Ma"gemcnt, 127 Cardinal Drivo Extension, Wilmingrota ati�Cr're me
"violin 10 days of receiptorth1j notice • 1840S
No response is considered ncc sam
You have been notil{ed by Certified Mail,
WAIVER SECTION
! understand (not a pier, dock, Moo ring Pilin s, brostic�va
bckamin)mn, distance of lS, from my urea of ri anon ter, b'DOhftwp-0r t
"isb ► 'aive !Ile setback, you A cress - I:nit�ss >'v�i
must initlt:l then roprive blal!k
1 do wishtp waive the IS!setback remittryt\tnt
i o�o wish re waive Jhe 15's
back rtaul�tmtrtt
1 , - T- Ihl_

?flame of Individuai Applying For Pit;
Address of Properry 3� + Q ,
rLet or Street Street or Road)
tv and Courfry )—CZ5
,jcrebv certify own property adjacent to the abo applying for this perms has described
are proposing. A description or drawitn , w th Shown
n °n tt
$ dimension,
C kecK
z have no objections to r pr,
if yOu have objections to whot is being proposod, f
Management, i27 Cardinal Drivo Exton'ion, Wilmin,
within 10 days of receipt of this notice, No response is c
YOU hove been notified by Certlned Mail,
WAIVER SEC -IQ,
I understand that a pier, dock, mooring pilings, brenkNva
bckaminimunt distance of IS' from my ores of rilaarion
�tiisb to the setbacl(, you must initial tho nppropri;
['(.. 1 do wishA waive the 15�seback reau
i a_ytcw waive tht (Ss
C.tbacK r

plicant: m (y 1 Permit #: S-)3 of
te:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer
nd in your Habitat code sheet.
)itat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fin
disturbance.
Excludes any
restoration and
temp impact
amount)
Dredge ❑ Fill L� Both ❑ Other ❑
�
q�
C
v
—7,
Dredge ❑ Fill Both ❑ Other ❑
Z S
2 I
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge 0 Fill ❑ Both ❑ Other ❑